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NURS 3512 acute & chronic > Week 12 Intra-op > Flashcards

Week 12 Intra-op Flashcards

1
Q

Why do we need a controlled surgical environment?

A

minimize the spread of infection

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2
Q

What can someone wear in the unrestricted area?

A

street clothes
(front desk/locker rooms)

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3
Q

What does someone wear in the semi-restricted area?

A

Surgical attire
cover all hair
(corridors between OR rooms)

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4
Q

What does one wear in the restricted area?

A

surgical attire
cover all hair
surgical MASK
(OR rooms and scrub sinks)

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5
Q

What are the 3 main tasks of the surgeon?

A
  1. determines need for surgical procedure and type
  2. does the surgery
  3. post-op care on unit
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6
Q

What are the 3 main tasks of the Anesthesiologist?

A
  1. Keeps patient alive (during and shortly after surgery)
  2. maintain anethesia during surgery (no one wants an awake patient on the table)
  3. Post-op care while in recovery room or PACU
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7
Q

What are the 6 tasks of the circulating nurse?

A
  1. unsterile field
  2. assess/position pt
  3. Pt advocate
  4. ensure OR runs well
  5. Instigates surgical time out (when they announce the patient )
  6. Document/gives report
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8
Q

What are the 3 tasks of the scrub nurse?

A
  1. Sterile field
  2. Hands on during surgery
  3. Passes instruments to surgeon
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9
Q

Which nurse is responsible for the “count” of all materials going into the patient?

A

both the scrub and surgical nurse

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10
Q

At what point are gowns and gloves put on ?

A

In the OR with assistance

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11
Q

What factors are considered when deciding type of anesthetic?

A
  1. length of procedure
  2. invasiveness of procedure
  3. past health HX
  4. pt/surgeon/anesthetist preference
  5. emergency and pt just ate?
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12
Q

What induction agent is first given in general anethesia?

A

propafol - sedative (unconscious)

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13
Q

What is the foundation of anethesia (we help the patient cough this out after)?

A

Inhalation agents via endotracheal tube

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14
Q

What are 3 examples of regional anesthesia?

A
  1. spinal anesthetic - no motor/sensory feeling
  2. Epidural anesthetic - nerve roots around spine
  3. local anaesthetic- nerve block
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15
Q

What are 2 good things about regional anesthesia?

A
  1. fast recovery
  2. no NPO required (not intubated) - good for emergency
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16
Q

Is an epidural a one time needle or a catheter for continuous drug delivery?

A

catheter for continuous drug delivery

17
Q

What is a spinal anethesia?

A

one time injection of anethetic and analgesia
- subarachnoid space (below L2)
- mixes with CSF
- autonomic, sensory, motor block

18
Q

What is an epidural?

A

injection of anethetic/analgesia in epidural space (lumbar or thoracic)
- drug binds to nerve root that enter/exit spinal cord
- sensory fibres blocked
- motor fibers not blocked
- can be one time dose or PCA

19
Q

Can a patient go back to the unit with an epidural?

A

Yes

20
Q

Would we anticipate a headache with an epidural or spinal and why?

A

Spinal b/c they may leak CSF. The brain doesn’t like this

21
Q

What do we monitor in people with Spinal/Epidural?

A

Hypotention
Pruritis
Urinary retention
N&V
Infection / Septicemia
Epidural hematoma (bleeding btwn inside skull and outer covering of brain)

22
Q

What is procedural sedation (conscious sedation)?

A

Mild or heavy deep IV sedation for minor surgery or diagnostic procedures

23
Q

What needs to be monitored when person is under deep procedural sedation?

A

Airway

24
Q

what two meds are used for procedural sedation?

A
  1. fentanyl (opioid)
  2. Midazolam (sedative/amnesic)
25
Q

What is a rare but life threatening event that can be triggered by anesthesia?

A

Malignant Hyperthermia

26
Q

What medication can cause malignant hyperthermia?

A

Succinylcholine

27
Q

What happens if someone experiences malignant hyperthermia?

A
  1. hypermetabolism- hyperthermia
  2. hypoxemia - hypercarbia
  3. tacycardia - tachypnea-dysrhythmias
28
Q

What saves a person in malignant hyperthermia?

A

Dantraline sodium
cool the patient

29
Q

What is the key to preventing malignant hyperthermia?

A

family history (highly genetic)
- make sure to ask !

NURS 3512 acute & chronic (29 decks)

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